Provider Demographics
NPI:1265691489
Name:BITTAR, NEVILLE (MD)
Entity type:Individual
Prefix:
First Name:NEVILLE
Middle Name:
Last Name:BITTAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 ENTERPRISE LN STE 201
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-1193
Mailing Address - Country:US
Mailing Address - Phone:608-274-2890
Mailing Address - Fax:608-274-2979
Practice Address - Street 1:6300 ENTERPRISE LN STE 201
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-1193
Practice Address - Country:US
Practice Address - Phone:608-274-2890
Practice Address - Fax:608-274-2979
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI160031744R1102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study